我院耐碳青霉烯类鲍曼不动杆菌的耐药性分析

Drug resistance of carbapenems - resistant Acinetobacter baumannii isolates and detection of metallo -β- lactamase

目的了解我院耐碳青霉烯类鲍曼不动杆菌的耐药性及其产金属β-内酰胺酶(MBLs)菌株的情况。方法采用MicroScan WalkAway 96检测耐碳青霉烯类鲍曼不动杆菌对23种抗菌药物的耐药性;采用Etest MBLs检测耐碳青霉烯类鲍曼不动杆菌产金属β-内酰胺酶。结果 42株耐碳青霉烯类鲍曼不动杆菌仅对头孢派酮/舒巴坦和米诺环素耐药率较低,分别为16%和32%;对氨曲南、阿米卡星、头孢噻肟、头孢他啶等21种抗菌药物高度耐药,耐药率均为93%以上。42株中有40株产金属β-内酰胺酶,其检出率为95%。结论耐碳青霉烯类鲍曼不动杆菌耐药现象极其严重,甚至呈泛耐药;产金属β-内酰胺酶是耐碳青霉烯类鲍曼不动杆菌的重要耐药机制之一;临床应根据药敏结果合理选用抗菌药物。

Objective To investigate the resistance characteristics of carbapenems - resistant Acinetobacter baumannii in clinical isolates and the production of metallo - β - lactamase. Methods Antimicrobial susceptibility was tested by McrioSean WalkAway 96. E test was used to screen metallo - β - lactamase positive isolates from carbapenems - resistant Acinetobaeter baumannii. Results The resistance rate to sulperazone and minocycline was as low as 16% and 32% repectively. Carbapenems - resistant Acinetobacter baumannii showed strong resistance to a variety of antibiotics. The rate of resistance was over 93.0%. A total of 42 carbapenems - resistant Acinetobaeter baumannii were isolated. In addition, 40 of the 42 carbapenems - resistant Acinetobacter baumannii were identified with metallo - β - lactamase. Conclusions Carbapenems - resistant Acinetobacter baumannii is pan - drug resistant.. The production of metallo - lactamase represents one of the main mechanisms of resistance to carbapenems in Acinetohaeter baumannii, suggesting that more attention should be paid to the resistance of Acinetobacter baumannii and reasonable use of antibiotics to curb the spread of resistant isolates.